J1 Visa?

I am a Canadian who recently got accepted into a DO school in the US (yay) and I am having a few questions regarding the VISA for residency/fellowship.

It has been my goal to do a residency in IM, and preferably with a sub-specialty fellowship afterwards.

I have recently learned that most programs offer J-1 VISA for residency, and few offers H1B. In the likely scenario that I will take on a J-1 VISA to complete my residency, will I have to go back to my home country for 2 years before applying for a fellowship? OR can I just continue my fellowship under the same J-1 VISA, considering I never stopped training? I am aware that the Statement of Need from Canada is kind of a pain (I have to write the test eh?)

I also know of the J-1 waiver program and I heard it is viable for people who finished their IM residency (as primary care providers, without sub specialty yet). It has always been my dream to work in Alaska for a while so I am not bothered by it. However I just want to know if this path is viable, and what happens AFTER the 3 year waiver job? I heard that since I worked on H1B status (the waiver job) for 3 years I can apply for a green card? Also, would doing the waiver job hurt my chance of getting a fellowship afterwards (as in, I am out of residency for 3 years)?

I am a Canadian who recently got accepted into a DO school in the US (yay) and I am having a few questions regarding the VISA for residency/fellowship.

It has been my goal to do a residency in IM, and preferably with a sub-specialty fellowship afterwards.

I have recently learned that most programs offer J-1 VISA for residency, and few offers H1B. In the likely scenario that I will take on a J-1 VISA to complete my residency, will I have to go back to my home country for 2 years before applying for a fellowship? OR can I just continue my fellowship under the same J-1 VISA, considering I never stopped training? I am aware that the Statement of Need from Canada is kind of a pain (I have to write the test eh?)

I also know of the J-1 waiver program and I heard it is viable for people who finished their IM residency (as primary care providers, without sub specialty yet). It has always been my dream to work in Alaska for a while so I am not bothered by it. However I just want to know if this path is viable, and what happens AFTER the 3 year waiver job? I heard that since I worked on H1B status (the waiver job) for 3 years I can apply for a green card? Also, would doing the waiver job hurt my chance of getting a fellowship afterwards (as in, I am out of residency for 3 years)?

Thank you very much for your help!

The Exchange Visitor Sponsorship Program allows 7 years total in J1 status, maximum, but not guaranteed.
You can train for three years in internal medicine. if you get a 'fellowship' (aka subspecialty), you would apply for another Statement of Need. You would continue to train without a break.

the home country presence requirement does not stop you from working/training in the US for the fellowship using the J-1 Visa. The thing to remember is that the two year home country presence requirement prohibits you from applying for an H1B visa or green card right after training.

The 'waiver' of the home county presence requirement is just one way the US cancels the 2 year requirement.

Thing is, if you really prefer to practice medicine in the US (Alaska), then IMHO you should not bother with the J1 visa, you should get the H1B visa. You get six years maximum with the H1B, and then you can apply for jobs in the US where ever you want without being limited to under-served locations in the US.

If you use the J-1, and decide to work in the US, you have to finalize your waiver job before you finish your training. Once you're done training, you can't apply for a waiver job, you have to go home for two years.

But don't take my word for it. The EVSP (ECFMG) will explain the rules of the J-1 in detail. There are hundreds of lawyers in the US who would be only too happy to take your money to explain the ways and means of waiver jobs.

I think the J-1 visa is still a very viable option. Notwithstanding the two-year home residency requirement, the J1 visa is actually pretty good.
It has substantially less tax for all your residency training years. Plus your significant other can work with a J2 visa in the US.
The ECFMG people will be very happy to answer any specific questions one has.